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Home My WebLink AboutPTARMIGAN ROOST BLK 2 LT 9Ptarmigan Roost Lot 9 Block 2 #020-042-77 Municipality of Anchorage Page DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL. SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: ~k'/~¢o~Or PIDNumber: O~O -.~ ~-'77 Name: ~¢-~-¥ .~/.,/le,.- Wastewater System: D New ~Upgrade Address: ABSORPTION FIELD Phone: ¢ ~- ~ 7/ B Deep Trench ~Shallow Trench B Bed Q Mound Q Other LEGAL DESCRIPTION Soil Rating: Total Depth from original grade: I, ~ GPD/Sq. Fb ~, Lot: Block: SubdivBion: Depth to pipe bottom from original grade: Gravel depth beneath pipe Township: I Range: ~ction: Fill added above original grade: Gravel length: I Number of lines: O~stance between lines: WELL: ~s ~ El New ~ Upgrade Gravel width: ~ Ft. / ~ Ft. Classification (Private, A,B,C): Total Depth: Cased TO: Total absorption area: Pipe material: ~_ Driller: Date Drilled: Static Water Level: Installer: Date installed: Yield:GPM [ Pump Set at: Ft. CasingHeightAboveGround:Ft. TANK SEPARATION DISTANCES ~ s.ptio u Ho~d~n, U S.T.,.~. TO Septic Absorption Lift Holding Public/Privat~ Manufacturer: Capacityin gallons: From Tank Field Static. Tank Sewer Lines ~C~0~¢ ~ ~ / ~ ~ Material: Number of Compadments: Su~ace Water ~tOo' >~o.' - - LIFT STA'DION Lot , Size in gallons: [ Manufacturer: "Pump on" level at: [ "Pump off" level ab I High water alarm Foundation Cu~ain Pump Make & Model ] Electrical Inspections pedormed by: Drain -- - I Remarks: C.y~e~ ~F~c~e t-z/~//~ BENCH MARK Location and Description: ~ Assumed Elevation: :~;-' ENGINEER'S SEAL Inspections performed by: ¢/~h&~ ~c4.,'m[~c Dates: 1st g/zo/~¢ ........... , Department of Health and Human Services approval ' '~ ' 724)13 (Rev. 9/91) MOA 25 PERMIT NO: SW990301 PID NO: 020..042-77 PAGF 2 OF 3 NEW 100' LONG x 5' WIDE so,. .... W. 0.5 GVL & 2 SAND BELOW PIPE "BULL RUN" VALVE "F" NEW 1250 GALLON SEPTIC TANK WELL 100' ORIGINAL DRAINFIELD SWING TIES: FROM: COR. "A" COR. "B" TO: S.T.C.O. "C" 49.5' 53' S.T.C.O. "D" 56.5' 6t' DBL. C.O. "E" 58' 63' VALVE "F" 59' 64' DRF. C.O. "G" 112' 119' DRF. M.T. "H" 102' 94' DRF. C.O. 'I" 109' 86' LOT 9, BLK. 2, PTARMIGAN ROOST S/D SEPTIC SYSTEM UPGRADE AS-BUILT INSPECTION PLAN VIEW FLATTOP TECHNICAL SERVICES 14530 ECHO STREET ANCHORAGE, ALASKA 99516 SCALE:I" = 40' DRAWN BY TFM NOVEMBER, 1999 PERMIT NO: SW990301 PAGE 3 OF 3 PID NO: 020-042-77 ' -2',~OIL COVER /2 RIGID INSULATION , -- i250 AL N ' 85.7 [ ~ I ~.~' V~ ,.v.~ ~ / ~ / _ n ~ BOTTO~ G~VEL ELEV 72 2 ~NEW 100' LONG x 5' WIDE SOIL ABS. D~INFIELD WITH 2' SAND AND 0.5' GVL. BELOW DUST. PIPE:. LOT 9, BLK. 2, PTARMIGAN ROOST S/D SEPTIC SYSTEM UPGRADE AS~BUILT INSPECTION PROFILE FLATTOP TECHNICAL SEP. VICES 1zl530 ECHO S'I'RF~ET' ' ANCHORAGE, ALASKA 99516 NOT TO SCALE DRAWN BY TFM NOVEMBER, 1999 MUNICIPALITY OF ANCHORAGE Dapadment of Health and Human Services On-Site Services Program 825 L Street, Room 502 P,O. Box 196650, Anchorage, AK 995~9-6650 (907) 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Aug 25, 1999 Expiration Date: Aug 24, 2000 Permit Number: SW990301 Legal Description: PTARMIGAN ROOST BLK 2 LT 9 Design Engineer: 0019 Flattop Technical Services Owner Name: Stacy Stiller Owner Address: 16220 Sandpiper Drive Anchorage. AK 99516-1915 Parcel ID: 020-042-77 Site Address: 016220 SANDPIPER DR Lot Size: 59079 SQ. FT. Total Bedrooms: 4 Permit Bedrooms: 4 This permit is for the construction of: [] Disposal Field [] Septic Tank ~] Holding Tank [] Privy [] Private Well [] Water Storage All construction must be in accordance with: 1, The attached approved design, 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AACS0 ). 3. The engineer must notify DHHS at least 2 hours prior to each inspection. Provide notification by calling (907) 343-4744 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: ~-----~' Date: TECHNICAL CIVIL & ENVIRONMENTAL ENGINEERING · ENERGY CONSERVATION & ANALYSIS THEODORE F. MOORE, P,E. 14530 ECHO ST. PH: (907) 345-1355 ANCHORAGE, ALA~8 KA 99516 August 12, 1999 M.O.A. DHIIS P.O. Box 19-6650 Anchorage, AK 99519 Dear Sirs: The purpose of this letter is to provide the required design narrative in support of our application for a permit to upgrade the wastewater disposal facilities on Lot 9, Block 2, Ptarmigan Roost S/D, located at 16220 Sandpiper Drive. The present system is no longer able to accept the wastewater load originating in the existing 4-bedroom residence. Soils logs, perc test results, a site plan, design drawings and specifications are enclosed for your review. The proposed system will be constructed in the vicinity of test holes #1 and 2. As can be seen fi'om the soil logs, the native material below 3 feet is a somewhat silty sandy gravel with measured pert rates of<l - 5 minutes per inch. Using the soil application rate of 1.2 gpd/sq, ft. specified in the wastewater ordinance, this 4-bedroom residence requires a total absorption area of (4 x 150)/1.2 = 500 square feet. Because bedrock was encountered between 8 and 9 feet, a shallow drainfield design is appropriate. The proposed 5' wide by 100' long drainfield design has a total absorption area of 500 square feet. The topography of the lot in the area of the proposed construction is along the base of steeper slope where the slope transitions down to 25% or less. A "Bull Run" diversion valve will be installed allowing future temporary reconoection to the original trench as desired after the absorption characteristics of the soil have had a chance to rejuvenate. The proposed project will have no significant impact on present or future water supply and wastewater disposal systems serving adjacent properties, nor will it have any significant impact on reserved space-surface and subsurface, or on drainage. Please give me a call at 345-1355 if you have auy questions on this submittal. Sincerely, Ted Moore, P.E. LOT 9 LOT10 SEPTIC AREA LOT8 CONSTRUCT 5' WIDE x 100' LONG SOIL ABSORPTION DRAINFIELD T.H. #1 ,' INSTALL NEW 8EPTIO 'rANK INSTALL "BULL RUN" DIV. VALVE / ~EA BAN D~ON XISTIN~G T'""" ~ SEPTIC 1;ANK #2 ,~ ORIGINAL , ' DRAINFIELD ,' WELL R 100' WELL ,' ,, LOT 9, BLK. 2, PTARMIGAN ROOST 8ID SEPTIC SYSTEM UPGRADE SITE PLAN FLATTOP TECIINICAL SERVICES 1 INCH = 50 FEET 14530 ECHO STREET DRAWN BY TFM ANCHORAGE, ALASKA 99516 AUGUS'r, 1999 NOTE: THIS IS NOT A SURVEYED PLAT. ALL LOCATIONS SHOWN ARE APPROXIMATE. CONSTRUCT 100' LONG x 5' WIDE SOIL ABSORPTION DRAINFIELD -----% "A" ~ WITH 2.0' FILl'ER SAND AND 6" GVL ~ ! / 4" DIA. F-810 PERF PIPE - - - - - - ' - --- - - ...... - .... __ _-_~~ -INSTALL BULL RUN DIVERTER VALVE ....... - - - / ~-~INSTALL DBL. C.O OR~G,NAL SO~L A~S. ~R~NCH ~ / ] ~ I ' ~ SEPTIC TANK PLAN VIEVV SCALE: 1" = 20' 2" RIGID INSU FILTER FABRI~ 3 1/2" - 2 1/2" SEWER GVL. 2' FILTER SAND-- MONITOR TUBE LEANOUT BOTTOM OF EXCAVATION SECTION "A - A" SCALE: 1" = 5' ORIGINAL GROUND LOT 9, BLK. 2, PTARMIGAN ROOST S/D SEPTIC SYSTEM UPGRADE PLAN AND CRO S S-SECTION FLATTOP TECHNICAL SERVICES 14530 ECHO STREET ANCHORAGE, AK, 99516 SCALE: AS SItOWN DRAWN BY: TFM AUGUST, 1999 Flattop Technical Services 14530 Echo Street, Anchorage, AK 99516 Phone (907) 345-1355 Lot 9, Block 2, Ptarmigan Roost S/D 16220 Sandpiper Drive Wastewater disposal system installation Specifications 1.0 General: 1.1 The scope ofthe project consistsofabandonment ofanexisting 1250 gallon septic tank and installation of a new 1250 gallon septic tank followed by a 100-foot long by 5-foot wide soil absorption drainfield containing a 2 feet of filter sand plus a total of lfoot of sewer gravel. 1.2 Construction shall be as depicted on the approved site plan and design drawings. Minor deviations from these drawings may be allowed or required by tbe engineer conducting the inspections. All construction procedures and material specifications shall conform with Municipal and State requirements. All separation distances shall be in conformance with Municipal requirements, unless specifically waived. 1.3 The contractor shall be responsible to obtain any necessary utility locates, and to work around any buried utilities. 1.4 The contractor shall provide adequate cover material and rough grading over ail system components to ensure that proper drainage is achieved after settlement and that there are no residual depressions. Insofar as possible the contractor shall minimize damage to trees aod existing lawn areas. 1.5 Unless specifically agreed otheiwvise, the homeowner shall be responsible for finish grading after the soil is compacted, as well as placement of topsoil and reseeding all areas disturbed by the construction. 2.0 Septic Tank: 2.1 The existing septic tank must be properly abandoned by thoroughly pumping, removing the top and backfilling with soil. 2.2 The new 1250-gallon, 2 compartment septic tank shall be Municipally approved and shall be set level on undisturbed soil. Each compartment shall be equipped with a watertight manhole cover and a 4" cleanout. If the tank is buried less than 4 feet, it shall be insulated with 2 inches of approved burial type, rigid insulation. 2.3 All pipe connections to the tank shall be equipped with wateiproof mechanical couplings. The waste line from the residence to the septic tank shall have a minimum slope of 1/4'" per foot, and the waste line between the tank and the soil absorption system shall have a minimum slope of 1/8" per foot. A double cleanout shall be installed within 5 feet downstream of the septic tank, and a "Bull Run" diversion valve installed allowing future reconnection to the original soil absorption trench. 3.0 Soil absorption system: 3.1 The soil absorption system shall be constructed by excavation a 5-foot wide by 100-foot long trench to a depth of 4' below original ground elevation at the location shown on the site plan. The long axis of the trench shall be parallel to an existing contour of the land. If layout considerations dictate, the trench may be constructed in two parallel segments. 3.2 The bottom of the excavation shall be level. Any compacted or smeared surfaces shall be raked to allow proper infiltration. Two feet of filter sand complying with Municipal specifications shall be placed in the bottom of the excavation. 3.3 A total of 1.0 feet of approved sewer gravel shall be placed in the bottom of the excavation with the perforated distribution pipes laid level such that the pipe inverts are no less than 0.5 feet above the bottom of the sewer gravel. Sewer gravel shall be 0.5" - 2.5" screened gravel, with less than 3% passing the #200 sieve. 3.4 Monitor tubes and cleanout pipes shall be of 4" diameter and installed ia the locations shown on the design drawings. The portion of the monitor tube extending through the sewer gravel shall be perforated. 3.5 Approved filter fabric shall be placed over the entire top surface of the sewer gravel. A minimum of 2 feet ofsoiI cover is to be placed over the filter fabric. If the soil cover thickness is less than 3 feet, two inches of rigid, burial type insulation is to be placed over the entire top surface of the gravel, in addition to the filter fabric. 3.6 The top surface of the cover material shall be raised a minimum of 6 inches higher than the surrounding terrain to allow for subsequent settlement, and shall be graded to smooth contours. Fill slopes shall be no steeper than 3:1. 3.7 Unless specifically agreed otherwise tbe homeowner shall be responsible for arranging to have the site finish graded after the backfill material has stabilized, and for placement of adequate topsoil and seed to promote rapid revegetation of all areas disturbed by the construction. 4.0 Inspections: 4.1 A minimum of 5 engineering inspections will be required during the course of the project: (I) initial stakeout with the contractor to establish the location of the system and to discuss the plans, specifications and construction procedures, (2) after the native material has been excavated to expose the infiltrative surface to ensure tbat it is level and at the right elevation, and conforms with the soil test information, (3) after the sand filter material has been placed, (4) after the sewer gravel is in place and the distribution pipes have been laid and connected up to the septic tank, but prior to placement of insulation or filter fabric, and (5) after rough backfill and grading is complete. The septic tank requires one inspection after it is set level and the piping connected, but prior to backfill. This inspection may be incorporated with any of the above inspections. 4.2 The installer shall coordinate the timing of the inspections with the engineer sufficiently far in advance to ensure the availability of the engineer. TEST HOLE FLATTOP TI:"CHNICAL SEF~VICI-'S 14539 ECHO ST. ANCHORAGE, ALASKA 99516 SOILS LOG -- PERCOLATION 'TEST LEGAL DESCRIPTION: Lot 9, Block 2, Ptarmigan Roost S/D DATE PERFORMED: July 19, 1999 PERFORMED FOR: Stac¥ Stiller 7 9 16 COMMENTS: Pt, SM Reddish sandy loam GP/GM Somewhat silty gravel Many cobbies and boarders Lenses of ML, GP GP/GM Coarse angular gravel B.H. (Bedrock) SLOPE O% SITE PLAN Depth to Groundwater Date ~roundwater /19/99 Monitor tube d~y 8/3/99 12,, _p~rkg- Add wat~l&~start -] 15% 35O/o~~--~ 15%~ 25% Clock Net Time Percometer Net Drop Time (minutes) Reading (inches) :i:19;40 __ 23 3/8 3:29:40 3:50:05 4:00:05 4:20:45 10 10 10 21 1/8 __23 1/2 21 1/4 23 1/2 21 1/4 4:30:45 PERCOLATION RATE 5 (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN fi,5 FI'AND 6.0 F'T Desiqn 5' wide drainfield on basis of 1.2 gpd/sq, ft. For added factor of safety construct with 2' filter_sand 2 1/4 2 1/4 2 1/4 PERFORMED BY FLA'FI'OPTECHNICALSERVICES. I ,,~ '~-'-'L. _ CERTIFYTHATTHIS'rESTWASPERFORMEDiN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: ,=~ //~- / -2~) ITEST HOLE LEGAL DESCRIPTION; DATE PERFORMED: PERFORMED FOR: DEPTH (feet) 6 14 15- COMMENTS; FLATTOP TECHNICAL SERVICI=_S 14530 ECHO ST. ANCHORAGE, ALASKA 99516 SOILS LOG -- PERCOLATION 'TEST Lot 9, Block 2, Ptarmigan Roost S/D J_ul~ly 19, 1999 Stac_y Stiller Pt. SM Reddish sandy loam GP/GM Somewhat silty, sandy gravel B.H. (Bedrock) SLOPE 0% SITE PLAN Depth to Groundwater Date Ng~q r_o un dwat~e r~ 7/19/99 Monitor tube d_w 8/3/99 Reading Bottom of perc hole ~_~b-soak #2 15% o,f 15% Clock Net Time Percometer Net Drop Time (minutes) Reading (inches) 15" -- 4:10 6" 4:12 4:14 _ 4:14:50 2 2 0:50 10 1/2" 12 1/2" Dr~ PERCOLATION RATE <1 (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN 4.5 PI'AND 5.0_ FT 4 1/2" 2 2 PERFORMED BY FLA~rOP TECHNICAL SERVICES. I~?".-~,~ ~ CERTIFYTHATTHIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: ~:~/ I "2.. /,~ ~-O~, MUNICIPALITY OF ANCHOR^GE /~'~-_~\ DEPAR'IMEN1 OF HEAI_I'H & ENVIRONMENTAl. PROTEC-IION ~,~ ~)) ENVIRONMENTAL ENQINEERINQ DIVISION ~ 825 L Street- Anchorage, Alaska 99501 Tdephone 264-4720 ~ ..... ~N-SI'rE SEWAGE DISPOSAl. SYS'TEM AND/OR WE[ . NSPECTION RE ~ORT NAME MAILING ADDRES~ LEGAL DESCRIPTION IF HOMEMADE: Inside length IT NO. No, of lines Len(jth of each p of tile to finish grade Length Width Nearest lot lino~ ~"C) PERMIT NO, DISTANCE TO foundatio Depth Driller --- DISTANCE TO: foundation Sewer line OTHER PIPE MATERIALS REMARKS DATE )- '- ~ '" ' ' HERLTH RND.~ENVIEONMENTFIL' F'ROTECTION [ I=FRLTIIEN r uF ..,~.,~ L STREET, RNE. HORRGE.. RK. 99~i81 i~_~ BPPLIOFINT SUN ~.ONSTRIICTION bTRR ROUTI= H BO)~ 474-E 995B~ ~44--t9 LOCATION HILLSIDE FIRE>] LEGRL E 9:8 ~: P]~RMIBRN ROOST S/D ) LOT SIZE 5B~OB SQLIBRE FEET TYPE: OF _.OIL ABSORPTION SYSTEM IS: [RFIIt~FI~LD HFtlqII"IUM NUMBER OF' BEDROOMS =, 4 SOIL RFIT,iNG (SQ FT?BR)= 83 THE REQUIRED SIZE OF THE SOIL FIBSORPTION SYSTEM"IS: E:.-, E< P -F H ;= ~; £-Ef-.IC~'TI-I=--:.::.'-'-::L [:--.E~F"TH= :~L.. ~; THE LENGTH DIMENSION IS TH[{ LENGTH (IN FEET) OF THE TRENCH OR DRFIINFIELD. THE DEPTH OF Ft TRENCH OR PIT I.S THE DISTFINC:E BETWEEN THE SURFFICE OF THE GROUND AND THI~[ BOTTOH OF THE EXCFIVFITION (IN FEET). -I-HE -FIREf~I£::I-~ b,i I I)TH ]ES ~_'~. (~lElO P-I---ET. THE GRFIYEL DEPTH IS THE MINIMUH DEPTH OF GRflVEL BETWEEN THE OUTFFILL PIPE fiND THE BOTTOM OF THE E:~:CAVFITION (IN FEET). SEPT Z C- TI:~I'-,II'.{ S I ZlE= ".]L2I:";O 13i=tL.L. FJNS PERMIT RPPI_ICFINT HRS THE RESPONSIBILITY TO INFORM TFIIS DEPFIR'mENT DURING THE INSTFII~LFITION INSPECTIONS OF FINY WELLS FIDJFICENT TO THIS PROPERTY FIND THE NUMBER OF RESIDENCES THFtT 'rile WELL HILL. SERVE. ......... TWO ,-'- ;,~ ::, I I['-.IS;F' E~]:T I Ot'-.I~S i~ I--~.'.E: RI~2-4. LI '[ RED ........ BFICKFILLING OF," RNY SYSTEH WITHOUT FINRL INSPECTION FIND APPRO',/FIL BY THIS DEPFtRTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTFINCE BETWEEN R WELL FIND ANY ON-SITE SENFIOE I)ISPOSRL SYSTEM IS 100 FEET FOR FI PR~',/~TE HELL OR t50 TO 200 FEBT FROM ~ PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC HELL. MINIMLIM B I:)TR[',ICE FROM R PRIYRTE WELL TO FI PRIYRTE sEwER~LINE I~ 2D FEET FIND TO FI COMMUNITY ~EWER LINE IS 75 FEET. WELL LOGS FIRE REQUIRED RND MUST BE RETURNED TO THE DEPRRTMENT WITHIN ~0 DRYS OF THE WELL COMPLETION. OTMER REQLIIREMENTS MRY FIPPLY. SPECIFICFITIONS RND CONSTRUCTION DIRGRRMS 8RE B',/RILRBLE TO INSURE PROPER INSTRLL. RTION. I CERTIFY THR'r :1.: I Fii',1 FFIMILIFIR WITH THE REQUIREMENTS FOR ON-SITE SEWERS FIND WELI_S AS SET FORTH BY TNE MUNICIPRLITY OF FINCHORFIGE. 2: I WILL INSTFILL THIS SYSTEM IN BCOOR. DFINCE WITH THE CODES. X".': I UNDERSTFIND THFIT THE ON-SITE SEWER SYSTEM MFIY REQUIRE ENLFIRGEMENT IF THE RESIDENCE IS REMODELED TO INCLLJDE I"IORE THFIN 4 BEDROOMS. SIGNED: ........................................................ FIPF'L, I CFINT SUN CONSTRUCTION ISSUED BY .............................................. DATE .............................. V4. 0 DEPRRTMENT OF ERL'rH RND EN'¢IRONMEN'rRL P' 'ECTION 825 ¢l~' ;:;TREET, RNCHCIRfRGE, RK. 26,$-4720 I.-.IEI_L_ Elf,lB, clr4--s ][ TE ~.~I_---_ L,.I E: I;-.-: F'ERI"I I 1-' PERMIT NO. ( L_OCRT I ON T'.r'PE OF SO:[/. RBSOREJTION S¥,STEM I...*' = ¢ SOIL RRTINCi MR×IMUM NLMBER OF BEDROOM::'; THE RE,~UIF. E.D SZZE OF THE ..()It. RB..-,ORPTTON 5~r'STEM IS: '-/-'_~_~___~r..~ __ THE LENGTH PIIdENSION IS TliE LENGTH <iN FEEl'> OF THE 'fRENCH OR DRRINFIELD. THE DEF'TH OF R TRENCH OR PIT IS THE DISTRNCE BETNEEN THE SURFRCE OF GROUND RN£:, THE BOTTOM OP THE EXCRVRTION (IN FEET>. THERE IS NO SET F.IIDTH FOR TRENCHES. THE GRRVEL DEPTH IS THE MINIMUId DEPTH OF GRRVEL BETHEEN THE OUTFFILL PIPE RND THE BOTTOM OP THE EXCRVRTION <IN PEET>. F~EI'_..;!IJIF;-:E[:, :=--;EF"TI6: TRNK _~;IZI:~: Ct I"'=l L_ L_ I_l ! PERMIT RF'PL. IC:RN-F HRS THE RF£SPONSIBILIT¥ TO INFORM THIS DEPRRI'MENT DI..IRING THE INSTRLL. RTION INSPECTIONS OP IIN¥ 14ELLS FIDJRCENT TO THIS PROPERTY RND THE '.II_IMBER OF RESIDENCES THRT ]'HE WELL NILL SERVE. ....... -FI.,-I C, r.~ 2 ) I I'-,I5F'E¥CT I Cir-,iS F:IRE REC-!I.J Z RE[: ....... E, RC:KFILLINC OF RNV SYSTEM NITHOUT FINRL INSPECTION RND F1F'F'ROVRL. ElY THIS DEPRR"F'MENT NILL BE :LIB,.ff:CI TO PROSEF:LITION. MINIMLIM DISTRNCE BETNEEN R WELL RND RNY ON-SITE SEI4RGE DISPOSRL S~?STEM IS 100 FEET FOR R PRIVRTE NELLJ OR 150 TO 200 FEET PROM R PUBLIC HELL DEPENDING UPON THE TYPE OF PUBLIC NELL NELL LOOS RRE REQUIRED RND Mus'r BE RETLIRNED TO THE DEPRRTMENT NITHIN _~0 DRYS OF THE HELL COMPLETION. OTHER REQUIREMENTS MRS' RPP[,.~'. SPECII--ICRTIONS RND CONSTRLICTION DIRGRRMS RRE RVRII_RBLE TO INSURE PROPER IN~TRLLRTION. I CERTIFr¥ TFIRT 1: I RM FRMILIRR WITH THE REC. IUIREMEN'r'z FOR ON-SITE SEWERS RND NEI.LS RS SET FOR-~N BY THE MLINICIP¢~LI'F¥ OF RNCtiORRGE. 2: I NII.L INSTRLL THE SN'~TErd IN RCCORDRNCE NITH TINE CODES. :~: I UNDERS'FRND TFIRT THE ON-SI'rE SEWER SYSTEM MRS' REQUIRE ENLRRGEMENT IF TFtE sRESIDENCEI GNE[,: ~~~~:~_~¢/IS REMODELED. 1'O INbL JDE' t MORE THRN ~. BEDROOMS. ~~ ~,~.~~¢ I =,...,UED BY r .... DR'rE_ _ , ~ . SOILS LOG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AN[) ENVIRONMENTAL PROTECTION Pouch 6-650, Anchorage, Alaska 99~02 276-222~ SOILS LOG .- PERCOLATION TEST SLOPE 10 11 12 13 DATE PERFORMED:__ SITE PLAN [] PERCOLATION TEST 14 16 16 17 18 19 20 WAS GROUND WATER Gross Net Depth to Net Reading Date Time Time Water Drop le~ / , --., PERCOLATION RATE (m TEST RUN BETWEEN FT AND FT PERFOR~' %MED BY: ~----'~'~'~,/~ 0..~_~-~'¥¥-"~ CERTIFIED BY: D AT E:///2'/~//~_~0 ~ ~ ~ L) ' - 72-006 (7/76) MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION SEP '~ 8 1980 RECEIVED ~ MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # (~¢:21~- Lr~L/,%),---~---I HAA# ~,~%I°~'~F;--5 \~ 1. GENERAL INFORMATION Complete legal description Lot 97 Block 2, Ptarmigan Roost Subdivision Location (site address or directions) 16220 Sandpiper off of Rabbit Creek Road Property owner Mailing address Lending agency Mailing address Agent Stacy Stiller 16220 Sandpiper, Anchorage, First National Bank P.O. Box 100720, Anchorage, AK Julie Curtis Address P.O. Box 100720, Anchorage, AK 99510 Un/ess otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: 4 % TYPE OF WATER SUPPLY: Individual well X Community well Public water NOTE: Day phone 345-2371 99515 Day phone 265-3588 99515 Day phone 265-3588 If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: X If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOA #21 STATEMENT OF INSPECTION BY ENGINI-'ER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm Enviro~me.n_tal M~na__j~emen~_q~ ._ Phone 562-2580 Address 907 E. Dowl~--~e~' A~_chorage_~ AK 99518 ...... 6.,~S SIGNATURE ~- Approved for' bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments //_ .Z - ~ Date. The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes professional engineer registered DHHS do not and their lending institutions in order to satisfy certain federal and state requirements. Employees of conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: Lot 9, Block 2, Ptan;~igan Roost Parcel I.D. A. WELL DATA Well type Private Log present (Y/N) Total depth 148 ' Sanitary seal (Y/N) yes If A. B, or C. attach ADEC letter. ADEC water system number Date completed 6/23/80 Driller ~ t,ens-~ ...... yes Casedto 24'-seated in bedt(~t,J~ngheight 2.3' Date of test Static water level unJmown Well flow 2 Pump level unknown SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot 103' Absorption field on lot 108' Public sewer main none Sewer service line none FROM WELL LOG 6123/80 Wires properly protected (Y/N) yes WATER SAMPLE RESULTS: Coliform 0 Date of sample: 10/20/92 B. SEPTIC/HOLDING TANK DATA Date installed 6/30/80 Cleanouts (Y/N) yes High water alarm (Y/N) Date of pumping latest g.p.m. AT INSPECTION 10/20/92 MUNICIPALi'JY OF ANCHORAGE i:NVI~,ONMENIAL SERVICES DIVISION 53' 8" £rom top of c~¢i~g. : ,.., ~. :, 1992 8,5 g.p.m. u.kno, RECEIVED ;On adjacent lots nearest lot is NE lot-over 200I ;On adjacent lots nearest lot is NE lot-over 200' Public sewer manhole/cleanout none Petroleum tank 25 ' Nitrate None Detected Collected by: Other bacteria None Detected Stan Dolloff Tank size 1250 gal. Compartments 2 Foundation cleanout(Y/N) yes Depression (Y/N) none Alarm tested (Y/N) none 5/6/92 Pumper Roto Rooter SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot 103' On adjacent lots NE lot-over 200' Foundation Topropertyline over 50' Absorptionfieid 5.5' Watermain/serviceline Surface water/drainage none none 25' none 72-026 (Rev 7/91) Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Vent (Y/N) High water alarm level "Pump on" level at Manufacturer Manhole/Access (Y/N) __ "Pump off" level at Cycles tested Meets MOA electrical codes (Y/N) SEPARATION DISTANCE-' FROM LIFT STATION 'FO: Well on lot On adjacentlots D. ABSORPTION FIELD DATA Date installed 6/30/80 _ Soil rating Length 82 ~ Width 3 ~ Total absorption area 447 fl~2 Depression over field (Y/N) none Results (pass/fail) _~3ass Peroxide treatment (past 12 months) (Y/N) no Surface water 85 System type Gravel thickness_ 1,5 ~ Total depth Cleanouts present (Y/N) yes Date of adequacy test 10/20/92 for drainfield 2,5' If yes, give date bedroorns SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Wellonlot 108' Onadjacentlots ~ 1cf.-over 200~ropertyline over 50' To building foundation 25' To existing or abandened system on lot none On adjacent lots ~ lot-over 200~utbank none Water main/service line none Surface water none Driveway, parking/vehicle storage area 50' Curtain drain none observed E. ENGINEER'S CERTIFICATION I certify that I have checked, verifie~d, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signature _ HAA Fee $ /~'~ Waiver Fee: $ Date of Payment ,/'¢ ~¢'-'0'5~ Date of Payment Receipt Number~'~27///0 0 (~ z/5~¢ 3 Receipt Number 72-026 (Rev. 3/91 ) Back MOA 21 APPLi('~.NT FILLS'OUT UPPER HA,. ONLY ' ~?,'t -, Buyer Address Zip Code Lending lnstitution ~ ~::~ ~x, ~ ~/,~ Phono Address Zip Code Realty Co. & Agent Phone Address Zip Code Street Locati~ Type of Residence ~Single Family ~ Multiple F~mily No, of Bedroo~ ~ Other ~ Individual A~ACH WELL LOG. A w~l log is required for all wells drilled since June 1975, ~ Community For wells drilled prior to that date, give well depth (attach log if available). ~ Public Utility ~ndiv~dual Year Individual Installed: ~ P~bl~c Utility When Connected to Public Utility: ~ Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH RE~EST BEFORE ~OCESSING CAN BE INITIATED. Inspector Inspector Inspector Iz~n ~/D ect o r Field Notes: MUNICIPALITY OF ANCHORAGE /~ Z) ~ DEPT. OF HEALTH & /j~/,..V///,~ ENVIRONMENTAL PROTECI'IC)N, .ECEI E ( ) APPROVED BEDROOMS 'OONDITION8 OF APPROVAL ~) DISAPPROVED ( ) GO~ITION~L APPROVAL* gAT~ ~ '~ '~' ~ ~ ~ ~ WelltoTank / ~ Septic T~k Size / ~ ~/ ~ February 15, 1984 Stacy Stiller 1513 W. 29th Avenue Anchorage, AK 99503 Subject: Lot 9, ~teck 2, Ptarmigan Roost Subdivision Approval for the in<~ividual sewer and water facilities cannot be granted until the followin{t items have been completed: L ~/~ Awell lo~ submitted to this office for our files review~ /o ~ The septic tank pumped with a receipt subl~itted to this '- ....depart~ent ~ Locate and expose the cleanout to the seepage pit and/or . ih!s is insure i:i~e leaching area ~or our inspection .... ' ' to minimum distance requirements are met between the well and sewer sy s t el~t. Please notify this Department for a reinsDection when the ~- e e any noted discrepancies have been corrected. If ~_h~r. are :~urther questions [31 ...... e cai]. this office at 264-4720° Sincerq.!y, Jim Roberts ,~1),~ cla ]. 1 st: Associate [mvz~om.ental" -~ ' ' D~,~F E RECEIVED INSPECTION APPOINTMENTS DATE DATE ,j'~ DATE 825 L Street - Anchorage, Alaska 99501 ENVIRONMENTAL SANITATION DIVISION SEP 1 8 1980 Telephone 264-4720 DIREOT)ONS: Complete a)m p~rts on page 1, mncompIete requasts will not ha procassed. Please allow ten (10) days for pFocessing, 1. PROPERTY OWNER PHONE PROPERTY RESIDENT (If dfffere~ ~rom above) PHONE 2. BUYER PHONE 5. LEGAL DESCRIPTION STREET LOCATION 6. TYPE OF RESIDENCE NUMBER OF~BEDROOMS [] One [~'"sT~G L E FAM I LY [] Two [] Five [] MULTIPLE FAMILY [] Three [] Six [] Other 7. WATER SUPPLY [;;;]~INDIVIDUAL* ' ATTACH WElL LOG. A well log is required for all wells drilled [] COMMUNITY since June 1975. For wells drilled prior to that date, give well [] PUBLIC UTI LITY depth (attach ID§ if available.) 8, SEWAGE DISPOSAL SYSTEM [~;]"'""]~DIvIDUAL/ON-SITE** (/¢~'~) YEAR ON-SITE SYSTEM WAS INSTALLED. [] PUBLIC UTI LITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010 (Rev. 6/79) ~ / THIS SIDE FOR OFFICIAL USE ONLY 1, TYPE OF RESIDENCE NUMBER OF' BEDROOMS [] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR E] SIX PERMIT NUMBER 2. WATER SUPPLY [] INDIVIDUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTI LITY Connection Verified LOG RECEIVED--'k~/'~-'' 3, SEWAGE DISPOSAL SYSTEM PERMIT NUMBER [] INDIVI DUAL/ON -SITE DATE INSTALLED []PUBLIC UTILITY ~, ~ Connection Verified INSTALLER []Septic Tank or (~Holding 'Tank ~- ¢.. Size: l;~f~~ If Tank is homemade SOILS RATING give dimensions: ¢~ TOTAL ABSORPTION-AREA MATERIAL Septic/Holding Tank /~-- Sewer Line Nearest Lot Line ~" DISTANCESwELL TO: Absorption Are? ~sorption Area to nearest Lot Line 5, COMMENTS '''X.PROVED FOR _"E ROOMS ID CONDITIONAL APPROVAL {letter must accompany certifieatel [~ DISAPPROVED 72-010 (Rev, 6/79)